Getting to Zero Pressure Ulcers Some Practical Advice Matt Tite Required additional resources: You must have copies of the Sustainability Model & Guide and Improvement Leaders Guide (ILG) on Sustainability to present this module. Strongly recommended that you mark applicable pages with placeholders / bookmarks as you will be referring to both frequently… Prepare flipchart template for the scoring exercise Put the flipchart of Ground Rules up created on their first day. Organising for Quality and Value Delivering Improvement Programme 1

Health Service Executive http://www.hse.ie/pressureulcerstozero/

How the NHS implements change…

7 Steps to measurement A road map of the ‘Alps’ 4 Collect Data 1 Decide Aim 2 Choose Measures 3 Define Measures 7 Steps to measurement 7 steps to measurement Say that measurement doesn’t just happen. It requires a well defined process. The diagram shows the 7 steps necessary to get measurement to work for you. We will be covering each of the 7 steps during the day. Move to next slide For reference Step 1 – Decide your aim Step 2 – Choose your measures Step 3 – Confirm how to collect and display your data Step 4 – Collect your baseline data Step 5 – Analyse and present your data Step 6 – Meet to decide what it is telling you Step 7 – Repeat steps 4 to 6 each month or more frequently 4 Collect Data 5 Analyse & Present 6 Review Measures A road map of the ‘Alps’ 7 Repeat steps 4-6

Health Service Executive http://www.hse.ie/pressureulcerstozero/

Applying Pareto to Harm Free Care You may know this but this is ‘evidence’ to support this 80% of the Harms

Pareto using the Trigger Tool

Step 2 – Choose Measures

Three types of Measures for a Good Project Outcome Measures Process Measures Balancing Measures The Donabedian Model The Donabedian Model is a conceptual model that provides a framework for examining health services and evaluating quality of care

Step 5 – Analyse & Present Presentation Dot plot Individual value Plot Interval Plot Bar Chart Run Chart SPC Pareto Scatter Plot Tally Chart Pie Chart Radar Chart Area Chart SPC Run Chart

Let me train you to be an analyst...

Mohammed A Mohammed THE LANCET • Vol 357 • February 10, 2001

How did we catch Harold? A taxi-driver in Hyde, who had a niche business ferrying elderly people to the shops, markets, and meetings, had noticed that twenty two of his regular customers, whom he judged to be in reasonably good health and whom he knew to be registered with Shipman, had died suddenly over a six-year period.

Walter A. Shewhart (early 1920’s, Bell Laboratories) Data contains both signal and noise. To be able to extract information, one must separate the signal from the noise within the data.

What does this data tell us? Patients with Ulcers in April 600 550 610 540 560 570 580 590 Congratulations, Aren’t we doing well Keep up the good work 2013 2014

What does this data tell us? Patients With Pressure Ulcers 650 600 550 500 450 400 350 300 All data needs to be put into context. April 2013 April 2014

Looking for a trend Time  Upward trend Time  Downward trend A run of 7 points is. All up, down or all above or below a centre line. 7 points all in downward direction 7 points all in upward direction

Looking for a trend Time  Above centre Time  Below centre A run of 7 points is. All up, down or all above or below a centre line. 7 points above centre line 7 points below centre line

http://www. institute. nhs http://www.institute.nhs.uk/productive_general_practice/general/knowing_how_we_are_doing.html

Import your data…

Use the Pareto Principle…

Create Statistical Process Control Charts…

The Royal Wolverhampton NHS Trust

“In God we trust, all others bring data” - W. Edwards Deming

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